Afraid of lymphadema
Hi,
Having done the surgery, now I am worried about lymphadema. My primary care dr. told me if the surgeon was good you will not get it, if he is not you will get it, as this is a delicate surgery.
My medical onco told me if my surgeon did not take all the lymph nodes then the likely hood of getting it is low.
What do I trust? I am almost two weeks out of surgery now, started light excercises as the dr. told me to, but still can't raise my arm up. There is a tightness in the area of the surgery, and can't move as easy...
Any tips from those who passed the exp.
Thanks
Comments
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I had a great surgeon. He told me my risk was low because he only took level I nodes from one side and 4 sentinel from the other… but even if he just removed the breast there is a risk for lymphedema. My BS told me that they can't always predict who will get and who won't. It is a life time risk.
I was given a prescription for compression sleeves/gauntlets for flying several weeks after my surgery. There were some precautions listed on there too.
Check this link out on how to protect against lymphedema.
http://www.stepup-speakout.org/riskreduction_for_lymphedema.htm -
Hi, Poly:
You are wise to be questioning and concerned about LE, and Iago is right...there is still a lot of mystery about why some women get it and some don't, but there are definitely things you can do to avoid it. The website she references is a great resource. Right now, just 2 weeks out from surgery, just do what your drs. tell you to do, and concentrate on resting and healing. But at the same time, read all you can and educate yourself on how to protect yourself from getting LE. My drs. told me nothing about it...I read about it myself, and took the steps necessary to avoid it, and still wound up with it!
I definitely did not want to get LE, but there are worse things...but it's much better to be 'worried' about getting it than actually having it!!!!
Take care, and if you need us we're here.
Suzanne
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Also check out lymphnet.org, the national organization, for good info.
I also highly recommend seeing a lymphedema PT -- their job is to know the details of LE and what you should and shouldn't do -- it was a huge help to me and relieved my mind a lot.
I had 17 nodes removed with my lumpectomy a little over a year ago. I was told my risk is low but it's always there so I'm cautious. My surgeon had me raising my arm above my head shortly after surgery (spider walks up the wall with my fingers) to relieve the tightness. I now have full range of movement. Two weeks isn't long -- give it time -- you should see improvement.
I was told never to lift anything over 30# but I've heard all kinds of ranges on that, seems everyone is told something different, so I use common sense. I have started using small weights because there's some good research that resistance exercise helps prevent LE. No guarantees, of course!
I don't use a sleeve when I fly (or any other time) because I don't have LE but I use the common sense things my LE PT told me to follow when flying: move around as much as possible, breath with your belly (it helps the lymph system flow properly), stay well-hydrated, stay away from salty snacks and caffeine.
I educated myself as much as possible to remove the fear of getting LE; knowledge is power, and when you know more about the possible triggers and what to do/not do, you'll probably feel a lot better. I know I did. Best of luck, and hang in there!
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Please see a physical therapist familiar with lymphedema. I had outstanding care at my hospital, but had to actively seek information about LE. I am low-risk (node-neg, SNE 6 nodes), but that doesn't mean much when you see women with 2 nodes removed getting this thing. I decided to wear a sleeve during travel to try and prevent the problem.
I honestly don't think a surgeon can or can't prevent LE. If they are removing nodes, they create a risk.
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Poly - your PCP is wrong about "good" surgeons never creating LE - some patients with top breast surgeons get LE, while other patients who have their surgeries done by pretty inexperienced general surgeons don't get LE. And your med onc is on the right track, but as the ladies here say, even just a simple mx with no node removal can lead to LE. I echo what these ladies here have said - you definitely need to educate yourself, because sadly the medical profession is very undereducated about LE. The websites they've referred you to are a great place to start.
See if your surgeon will give you a referral to a certified LE therapist - you can get evaluated and get valuable information about preventative measures you can take. Your instincts to ask questions about LE and to be pro-active are right on target. If tightness turns out to be cording (feels like a cord running down your arm - in my case it ran from my armpit to my wrist) that is associated with an increased risk of LE, so you definitely want to check it out if you feel cording. Otherwise, it is normal to still be somewhat tight after 2 weeks.
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Poly: I can echo the responses here. I had a left mastecomy with aggressive node removal. My arm was sore and tight for weeks, but I tried to move it gently on a daily basis. My range of motion improved, but last summer my left arm became painful to touch and I noticed mild swelling. My PCP suspected LE but ordered an ultrasound. Sure enough I had DVT blood clots in the left arm which they treated for 3 months with coumadin. The clots stabilized and I was cleared for LE therapy. I can now manage my own condition successfully and have been told what to watch for that might cause big trouble. Any disruption of the lymph system puts you at risk for LE, and it's not under the control of the surgeon. Start looking now for a trained LE therapist BEFORE you think you need one. The LE therapist in my area had a months long waiting list, but I found a therapist in private practice who is fantastic. And you know the only reason my onc group doesn't refer patients to this therapist? - because he is a man. Unbelievable. Isn't that against the law? Anyway, he was gentle and sensitive, and most important - well-trained and effective. I feel empowered being able to manage my own care now and he's just a phone call away if I have questions. If you catch it early your life will barely skip a beat! And the massage isn't bad either.....
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